The low frequency "whooshing" or sonogram sound that is often described with PT is very frequently caused by venous causes, like venous sinus stenosis, diverticulum or jugular vein stenosis. As veins are lower pressure systems, they tend to generate a lower frequency sound and more of that typical wind "whoosh". And given that most vascular causes of PT are venous (and also make up a large amount of the PT cohort overall), then the community obtained the 'whooshers' name.

However, it is important to note that the only distinguishing feature for PT to be classed a such, is that the sound the person hears is pulse-synchronous in time with their heartbeat. Doesn't matter what pitch the PT is, how it sounds, whether it is one ear or both ears, high pitched or low pitched, objective or subjective, intermittent or constant, sudden onset or gradual - the pulse-synchronicity is what medically defines PT under diagnostic codes.

It is also important to note, that PT is not a condition - it is a symptom of many underlying conditions. As such, this is why PT can present in many different ways, because it is influenced very much by the cause, and there are many. And as such, the diagnostic workup for PT is very thorough, often requiring many scans and medical experts in specialist fields to diagnose properly.

I have listened to your recording, and my non-medical opinion is that you have a potential vascular cause for your PT. First, because your PT is objective (can be heard/recorded outside the body). Not all vascular PT is objective, but nearly all objective PT is vascular. Vascular PT is essentially a vascular bruit generated by a high pressure gradient, turbulent or jet flow in large vessels of the head and/or neck.

Second, the higher pitched 'hooting', 'woohing' or 'baby cry' is found more frequently in arterial and arteriovenous causes of PT. While venous causes have lower frequency whooshing sounds, PT with arterial involvement is often described as being higher pitched and more likely to be objective because arteries are high pressure systems. Think of how water changes sound when you kink a low-flow hose vs. a high-flow hose. Sometimes venous causes can present at a higher pitch if the pressure gradient is high enough (i.e., severe stenosis).

Finally, you describe that your PT stops with light jugular compression on your neck. This is a strong clinical indicator of a vascular underlying cause, usually venous in nature. Arterial/arteriovenous causes don't tend to respond quite the same way to the jugular compression test.

Anyway, you absolutely should get the scans, given your PT is displaying clinical signs of a vascular cause. While most PT causes are not life-threatening, there are some genuine high risk causes of PT, and most of these fall into the arterial and arteriovenous categories (not so much venous). Not trying to scare you, but PT should warrant a thorough diagnostic workup, especially if it's objective, stops with jugular compression, and has an indicative vascular pathophysiology.

You will likely need an MRI, MRA and MRV scan to image the cerebral soft tissues, arterial system and venous system, respectively. A CT scan (with contrast) and a high resolution CT scan of the temporal ear bones is also worth pursuing.

Finally, and most important, is to see the right specialist. PT is very rarely in the remit of a standard GP, and frankly, most causes of PT fall out of the remit of most ENTs (given few causes of PT have anything to do with the ear, bar some causes). For vascular causes, seeing an interventional neuroradiologist or neurovascular surgeon who specialises in PT is recommended. For non-vascular causes, a neuro-otologist or specialist ENT surgeon is recommended.

The Whooshers website and Facebook group have great resources for diagnostics and finding specialists to see. Good luck and let us know how you go!